CaroMont turns on TV doctors to treat strokes

Published: Wednesday, May 15, 2013 at 06:14 PM.

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CaroMont Regional handles 55 to 60 strokes a month, which means doctors see two to three stroke patients a day, Love said.

Three neurologists are on staff now. The hospital is in the process of hiring a fourth.

It’s not cost effective to have a neurologist on staff all the time for the two to three stroke patients the hospital sees each day, Love said.

The hospital was looking at using the technology before it encountered staffing issues, she said.

Heidi Rubin, manager of training and education for Specialists on Call, said the only hospitals that can afford to have neurologists at their beck and call are teaching hospitals. Community hospitals like CaroMont don’t have access to those resources.

Demand for neurologists will grow faster than supply, according to a study by the American Association of Neurology.

When Doug Paige experienced what he thought was a stroke Wednesday morning, it wasn’t a neurologist at the hospital who diagnosed him.

A neurologist working miles away checked Paige’s symptoms via a TV screen and high-tech camera.

People being treated for a stroke at CaroMont Regional Medical Center have been examined using “telemedicine” since Feb. 18. The hospital partnered with Specialists on Call Inc. to provide a network of neurologists who can see stroke patients using technology similar to Skype, but with more advanced technology.

How it works

When an ambulance takes a patient to the hospital, the emergency services employee designates the situation as a stroke if the patient has stroke-like symptoms. That lets the hospital know to expect a stroke patient.

A doctor in the emergency department evaluates the patient, sends that person to have a CT scan and contacts Specialists on Call for a neurologist, said CaroMont stroke coordinator Tristy Love.

The company has three neurologists on call all the time.

The long-distance neurologist receives a copy of the CT scan and examines the patient with a nurse at the patient’s bedside to assist. A cart carrying a TV screen with a camera attached allows two-way communication between neurologist and patient.

The neurologist can use the camera to zoom in close enough to check a patient’s pupils. A nurse helps lift arms and legs and test a patient’s sensitivity to touch.

Patients typically see a neurologist within 15 minutes of the hospital contacting the Specialists on Call system. An examination lasts about 20 minutes.

The neurologist and an emergency department doctor coordinate after the examination to come up with a care plan. The neurologist sends his exam report to the hospital to put in the patient’s file.

CaroMont has 17 neurologists who have been certified to work with the hospital. Each has to have the same certifications and training as a neurologist physically working there.

Why use technology?

CaroMont Regional handles 55 to 60 strokes a month, which means doctors see two to three stroke patients a day, Love said.

Three neurologists are on staff now. The hospital is in the process of hiring a fourth.

It’s not cost effective to have a neurologist on staff all the time for the two to three stroke patients the hospital sees each day, Love said.

The hospital was looking at using the technology before it encountered staffing issues, she said.

Heidi Rubin, manager of training and education for Specialists on Call, said the only hospitals that can afford to have neurologists at their beck and call are teaching hospitals. Community hospitals like CaroMont don’t have access to those resources.

Demand for neurologists will grow faster than supply, according to a study by the American Association of Neurology.

About 16,366 neurologists practiced medicine in the U.S. in 2012.

By 2025, demand for neurologists will outpace supply by about 19 percent, with 3,380 more neurologists needed than available.

Results

Barbara Paige, Doug Paige’s wife, said the neurologist doing the video consultation was professional and informative — and better than if a neurologist had been in the room.

“He gave us more information than anybody has ever given us,” Paige said. “He was very educational. He explained everything in detail.”

Since Feb. 18, CaroMont has used the video examination system for 122 stroke consultations, said Rubin. Of those, 12 resulted in patients receiving a drug that dissolves blood clots.

Time makes all the difference when dealing with a stroke, said Allen Marsh, director of the ortho/neuro service line at CaroMont. The hospital can change the outcome of a stroke if a person gets to the hospital in time and gets treated quickly.

“Time is brain,” Marsh said.

You can reach Amanda Memrick at 704-869-1839 and twitter.com/AmandaMemrick